Individual
TIFFANY CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1143 LIBERTY ST NE, SALEM, OR 97301-1047
(503) 361-0380
(503) 361-0383
Mailing address
7882 WATERLOO ST NE, KEIZER, OR 97303-2474
(503) 463-6534
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/12/2006
Last updated
07/08/2007
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